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HEB PHARMACY #475
CHC11298-00 TRAVIS COUNTY HEALTHCARE DISTRICT
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Covered Entity Details
Entity Name
TRAVIS COUNTY HEALTHCARE DISTRICT
Subdivision Name
CommUnityCare Kramer Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CHC11298-00
Entity Address
2115 KRAMER LN
STE 100
Austin, TX 78758
Grant Number
H80CS11298
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
HEB PHARMACY #475
Pharmacy Address
1080 W. HWY 290
ELGIN, TX 78621
Pharmacy Comments
Contract Details
Approval Date
4/25/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaeson Fournier, CEO
(512) 978-9050 Ext: 5125954337
Contract Pharmacy Representative
HEB Pharmacy
Jay Beuche, Manager Contracting
(210) 938-8578
Signed By Date
4/25/2019
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